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Sunday, June 23, 2013

Since Acupuncture Today has chosen not to publish in their pages my response to Jake Paul Fratkin’s article “The Miracle Cure for Losing Weight.” I have decided to publish it here.

(First submitted January 24, 2013, modified today.)

Dear Editor of Acupuncture Today and Acupuncture Profession,

I read with interest and dismay Jake Paul Fratkin’s article “The Miracle Cure for Losing Weight.” I studied and implemented the so-called Paleo diet for about 15 years during which I came to understand the major flaws in its theory and practices. I also was the only Chinese medical presenter at the first (2011) Ancestral Health Symposium on the relevance of Paleolithic nutrition to modern humans, so I feel a responsibility to comment in detail.

While I agree that we have no miracle cure for weight loss, I disagree with the idea that a low starch Paleo diet based on meat, fish, and eggs with some fruits and vegetables accurately represents “the diet of our ancestors” and serves as a healthy approach to weight loss.

Prehistoric humans of the paleolithic period had no known control over their food supply and probably took every opportunity to eat the richest foods available to them. Ethnographic data indicates clearly that, due to seasonal fluctuations in wild food supplies, both non-human primates and non-agricultural people had a feast and famine lifestyle that allowed abundance during some seasons but enforced significant caloric restriction and weight loss in others. According to Chakravarthy and Booth, this pattern most likely affected paleolithic humans:

"Because the success of finding food in the hunter-gatherer
society was never guaranteed (14),
it was not unusual for our Late-Paleolithic (50,000-10,000 BC)
ancestors to undergo periods of feast (during food abundance)
intermixed with periods of famine (under drought
conditions, an unsuccessful hunt, or inability to hunt due to physical
inactivity
or illness), thereby resulting in cycles of
feast-famine as well as physical activity-rest." 1

Consequently, any Paleolithic humans who engaged in nutritionally motivated hunting would have done so in order to increase their food energy intake in order to maintain or gain weight, not in order to achieve weight loss. Further, wild game flesh has substantially less fat and kcalories than the fattier animal
flesh in modern supermarkets. In view of this, the "Paleo diet" theory that overfed sedentary modern humans who need to lose excess adipose should regularly eat the fatty flesh and eggs found in supermarkets because active, underfed, extremely lean prehistoric people who struggled to meet their basic kcaloric needs ate lean game flesh or eggs whenever possible lacks basic credibility.

People wanting to get lean should emulate the food choices of people wanting to get fat? Source: Alerte Environnement

The fossil record does not provide us with detailed diet diaries of prehistoric humans so most ideas of Paleo diet plant-animal ratios represent speculation. The modern human genome primarily developed in Africa. Modern African foragers (Ju/'Hoansi and Hadza) succeed in killing large but lean game animals only about once a month, only after large energy expenditure in hunting, so these hunter-gatherers, like other primates, rely primarily on fruit, vegetables, nuts, and seeds for sustenance. 2

Hawkes compared the energy delivery of hunting to gathering among the contemporary Hadza and found that hunting provided a lower energy return than gathering done by any but the youngest members of the tribe:

“The household share is a rough estimate of the hunter's contribution to family consumption when he hunts big game. The overall average acquisition rate for hunters is 4.89 kg/day (live weight; Hawkes et al. 1991). If we assume that the hunter's household keeps 10%, then his "take-home" rate is .49 kg/ day.3 Hadza men spend 4.13 hrs/day hunting on average, making their average take-home rate .12 kg/hr....

“The rates for large game can also be compared with gathering plant foods by converting kilograms of meat to calories. If large animals are estimated at 1500 Cal/kg live weight (following Lee 1979), a rate of .12 kg/hr (live weight) gives 180 Cal/hr. This rate is lower than all but the very youngest children earn gathering (Blurton Jones et al 1989; Hawkes, O'Connell, and Blurton Jones 1995). In the long run, big-game hunting is inferior to available alternative strategies for provisioning families.” 3

It seems improbable that prehistoric humans, who had lesser technology (not even possessing the bow and arrow), had greater hunting success. In contrast, the average resident of a modern nation can procure as much meat as she wants with a credit card. Further, like other wild animals but unlike the average modern patient seeking weight loss, Paleolithic humans hosted cholesterol- and iron- depleting, antiatherogenic parasites [4, 5, 6, 7], which would have protected them from two harmful components of animal flesh. 8 I discussed problems involved in applying supposedly Paleolithic diets to modern populations in my 2011 Ancestral Health Symposium lecture in which I integrated principles of Chinese science with biomedical nutriton. 9

Fratkin identifies China and France as two cultures that “manage to stay thin.” Remarkably, neither of these cultures avoid all of the starchy “white” foods that Fratkin blames for obesity. However, while according to the UN OECD, the rate of obesity in France (9.4%) is less than a third of that in the U.S. (30.4%), their rate is still three times that of Japan or South Korea (each 3.2%). While the French eat substantial amounts of animal flesh and saturated fats (~40% of energy as fat 10), the Japanese diet in comparison supplies contains relatively little animal flesh, particularly from land animals, and supplies only 29% energy as fat [11] and about 60% energy as carbohydrate [12], mostly from white rice.

Further, the French have had their current high animal product and fat intake for only a relatively short period of time, which confounds claims that their diet doesn't promote obesity or heart disease [ 31] because evidence suggests the effect does not appear on a population level until the population has maintained their high fat intake for at least 25 to 35 years. A murine study indicates that high-fat diets produce a gradual enhancement of fat mass over four generations [32], which would amount to at least 80 years for humans.

The very lean Chinese eat a diet based on rice, noodles, and steamed bread. The Cornell-Oxford-China Health Project found that the average Chinese person gets less than one percent of his total kcalories from animal protein (Americans get an average of ten percent of energy from animal protein). The average Chinese diet supplies 70 to 80 percent of calories as carbohydrate, mostly from rice and noodles, but less than 15 percent of calories from fats (Americans get about 35 percent of calories from fats).[13] Chinese remain lean despite consuming one-third more kcalories (per kg body mass) than Americans. [14]

In China and elsewhere, obesity increases with fat and animal flesh intake, and decreases when carbohydrate-rich plant foods such as rice and pasta replace fat and flesh. In the Adventist Health Study, only the vegans had an average BMI in the healthy range, whereas the average BMI of lacto-ovo vegetarians, pesco-vegetarians, semi-vegetarians, and nonvegetarians all indicated overweight or obese, and the prevalence of overweight or obesity and diabetes increased directly with the increased variety and amount of animal product in the diet. [15] In the EPIC-Oxford study, vegans had the slowest rate of weight gain. [16] In a Belgian population, people reporting a higher intake of animal protein and lower intake of plant protein had a higher body mass than those with lower intake of animal protein and higher intake of plant protein. [17] In the U.S., meat consumption associates positively with both obesity and central abdominal obesity. [18]

The whole idea that carbohydrate-rich foods—namely, plants–– uniquely cause obesity lacks scientific foundation. More than 50 years of scientific research has shown that almost all stored body fat comes from excess dietary fat [19] and that, because fat supplies more than twice as many calories per gram as either protein or carbohydrate, fat balance primarily determines energy balance.[20] That is, dietary fat intake primarily determines the caloric content of the diet and body fatness. As stated by Swinburn and Ravussin:

“Under normal conditions, carbohydrate, protein, and alcohol are not converted to fat. Glycogen and protein stores are closely controlled, and increasing the intake of nonfat nutrients stimulates their oxidation rates proportionally. Thus, chronic imbalance between intake and oxidation of nonfat nutrients cannot lead to obesity."[20]

Generally, animal flesh, dairy, and eggs provide more fats and have a higher caloric density than fruits, vegetables, grains, or legumes.

Fratkin advises avoidance of “Bread, pasta, cookies, cakes, pastries, cheese, yogurt, milk, ice cream, and all desserts.” Lean Chinese people eat steamed bread and pasta, but usually without adding much if any flesh, butter, cheese, mayo, or oils.

Bread and pasta have little fat and low energy density when not loaded with fatty condiments or sauces. One study found that overweight young men assigned to eating 12 slices of white bread daily (without fatty toppings) lost 14 pounds in 8 weeks.[21] The rest of the items on Fratkin's list ("...cookies, cakes, pastries, cheese, yogurt, milk, ice cream, and all desserts") supply 50 percent or more of their calories as fat or sugars. Someone wishing to lose body fat should eliminate those items from the diet, not because they are “white,” high in carbohydrates, or absent from Paleolithic diets, but because they are high in fat, refined sugars, and calories.

Besides promoting obesity, diets high in animal products provide excessive cholesterol and saturated fats. Based on more than 50 years of accumulated evidence establishing the causal relationship between dietary lipids and cardiovascular disease, the Food and Nutrition Board of the National Academy of Sciences states that any incremental intake of cholesterol or saturated fatty acids increases coronary heart disease risk.[22] Humans do not require dietary cholesterol or saturated fats. All flesh foods (meat, fish, poultry) contain similar amounts of cholesterol (wt/wt) and eggs have the largest cholesterol content of commonly consumed foods. Animal foods also constitute the primary dietary sources of saturated fatty acids.

Dietary animal protein, cholesterol and saturated fatty acid intake also show positive epidemiological links with diabetes, cancer, Parkinson’s disease, Alzheimer’s disease, and autoimmune diseases, we have identified plausible biological mechanisms by which dietary animal food intake may promote these diseases, and reduction or elimination of animal flesh, fat, and cholesterol have been shown in numerous clinical trials conducted over the course of 100 years to ameliorate or eliminate these diseases [27]. Therefore, a meaty Paleo diet probably puts patients at an increased risk of cardiovascular, metabolic, neurological, and autoimmune diseases.

Recently, a panel of experts ranked the Paleo diet as the least desirable approach to general health or weight loss due to its nutritional imbalances and a lack of evidence for safety or efficacy. [28] John McDougall, M.D., a leader in lifestyle and nutritional medicine with more than four decades of experience using plant-based diets to reverse obesity and chronic disease, has written a thorough critique of the Paleo diet, citing evidence that prehistoric human diets included starchy foods.[29] In fact, human saliva contains more of the starch-digesting enzyme amylase than any other species, clearly indicating that we have specific genetic adaptation to a starch-rich diet.

The Paleo diet lacks evidence of safety or efficacy and may put patients at well-known risk. Moreover, it contradicts the principles of traditional Asian nutrition and ethics (humanity and nonviolence).

"The honorable and upright man keeps well away from both the
slaughterhouse and the kitchen. And he allows no knives on his table."
Confucius

Ironically, more than 100 years of biomedical nutrition research indicates that plant-based diets similar to traditional rural Asian diets prevent and with modification may reverse cardiovascular, metabolic, and immune system diseases.

9 Posted on YouTube at http://www.youtube.com/watch?v=PIB6C5cy-KQ, and slides available at http://www.slideshare.net/ancestralhealth/ahs-slidesdon-matesz.

10 Razanamahefa L, et al. Dietary fat consumption of the French population and quality of the data on the composition of the major food groups. Bull Cancer 2005 Jul; 92(7):647-57. http://www.ncbi.nlm.nih.gov/pubmed/16123004

Most Published Research Findings Are FALSE

In the August 2005 publication of the online PLOS, John Ioannidis thoroughly explained "Why Most Published Research Findings Are False." He showed that "Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias."

I don't remember when I first read his paper (probably no later than 2010), but I do know that I didn't begin to take him very seriously until about February 2017. Up until then, I thought that I could discover the truth about diet, nutrition and health by sorting through and analyzing published diet and nutrition research, which to say the least presents contradictory findings from different camps with different biases.

In late 2016, after more than 5 years eating an apparently nutrient-dense, high protein vegan diet, I had a blood test that showed that I had significantly low levels of globulin and phosphorus, indicating that I was likely not getting adequate protein or phosphorus from that diet.

Since then, I have worked on ridding myself of the belief that published diet and nutrition "science" or research is credible by virtue of its publication. I have worked on switching to relying on my own direct experience and senses of need, preference, taste, and satisfaction to guide my food choices. I am hoping to help others do the same.

If I could relay only one message from this point forward it would be: DON'T PUT YOUR FAITH IN SCIENCE AND DON'T RELY ON AUTHORITIES. BECOME SELF-RELIANT AND AUTONOMOUS.

Disclaimer

At one time I used this blog to explore and support the theory and practice of modernized, highly animal-based paleo and low-carb diets.

As I evolved, I became a paleo-diet heretic, and this blog became an exploration and presentation of the evidence values that support the practice of a whole foods plant-based diet.

Everything changes, and my experience, knowledge and understanding are no exception. In short, I have found the weaknesses and faults in plant-based ideology and practice as well.

I have tried to digest and assimilate the apparently conflicting information coming from the opposite ends of the diet debates (meat-based and high-fat vs. plant-based high-carbohydrate).

I have incorporated that new information into my world view and perspective and in the process revealed and corrected my errors when necessary.

The Chinese sage Chuang Tzu observed: "Tao is obscured when men understand only one pair of opposites, or concentrate only on a partial aspect of being. Then clear expression also becomes muddled by mere wordplay, affirming this one aspect and denying all the rest. The pivot of Tao passes through the center where all affirmations and denials converge. He who grasps the pivot is at the still-point from which all movements and oppositions can be seen in their right relationship... Abandoning all thought of imposing a limit or taking sides, he rests in direct intuition. "

Through understanding and experimenting with the dietary opposites, in late February 2017 I came to an understanding of the still-point between the extremes and the role of "intuition" from one's True Nature in solving the apparent dilemma.

About Me

I am a member of MENSA who has not always made smart choices. I have a master's degree in philosophy, and do my best to pursue truth and virtue. I have made mistakes in public, and have not been afraid to admit it. I believe that if I'm not making mistakes, I'm not learning or growing or living fully. Like Thoreau, I believe that "life is an experiment to a great extent untried," and that a philosopher should show by example a better way of life, not just spout doctrines and arguments. I value freedom and abhor slavery. I have a master's degree in Oriental medicine and the course work equivalent of a bachelor's degree in nutrition. I seek health, fitness, and longevity through self-discipline in physical training and food. In short, I practice macrobiotics: philosophy, freedom, fitness, and food. Hopefully others can learn from my successes and my mistakes.